PT"

DOCUMENT RESUME

ED 026 769 EC 003 038

By-Hall, David; And OthersTo Develop Work Evaluation and Work Training Techniques Designed to Facilitate the Entry of Mildly MentallyRetarded into Service Occupations. Final Project Report.

Institute for the Crippled and Disabled, New York.Spons Agency-Vocational Rehabilitation Administration (DHEW), Washington, D.C.

Pub Date. 31 Aug 65Grant RD 1588 -P65Note-39p.EDRS Price MF-$0.25 HC-$2.05Descriptors-Curriculum Design, Custodian Training, Educable Mentally Handicapped, *Exceptional Child

Research, Food Service Workers, Health Services, Job Analysis, Job Skills, Job Training, *MentallyHandicap_ped, Occupational Surveys, On the Job Training, Program Design, *Program Planning, Rating Scales,Service Occupations, Service Workers, *Vocational Rehabilitation, Vocational Training Centers

Identifiers-Tower SystemA project to develop a system of vocational evaluation and training to help the

mildly mentally retarded (10 50 to 79) enter certain service occupations is described.Methods of procedure are discussed; these include research reading and surveys ofboth facilities for the retarded and commercial facilities. Specifications of jobs arepresented in analysis charts; basic job factors and related work factors are outlined.Job activities and a training curriculum outline are given for the areas of janitorialand building maintenance, food service and handling, and hospital service work.Additional discussions are of on-the-job experience, and recommendations for thedemonstration proiect including the project staff, client source, program schedule,and an outline of the proposed demonstration project. Eleven exhibits are presentedgiving further information on the job survey and on job evaluation; a bibliography lists32 items. (LE)

U.S. DEPARTMENT OF HEALTH, EBUCATION & WELFARE

.0 OFFICE OF EDUCATION

IN-C) THIS DOCUMENT HAS BEEN REPRODUCED EXACTLY AS RECEIVED FROM THE

C1 PERSON OR ORGANIZATION ORIGINATING IT. POINTS OF VIEW OR OPINIONS

CD STATED DO NOT NECESSARILY REPRESENT OFFICIAL OFFICE OF EDUCATION

CI POSITION OR POLICY.

FINAL PROJECT REPORT(September 1, 1964 - August 31, 1965)

I . IDENTIFICATION

A. The title of this research planning project is:

"TO De'VELOP WORK EVALUATION AND WORK TRAINING TECHNIQUESDESIGNED TO FACILITATE THE ENTRY OF MILDLY MENTALLYRETARDED INTO SERViCE OCCUPATIONS."

B. The project is being carried through with the support of

Vocational Rehabilitation Administration of the United States

Department of Health, Education and Welfare as RD-1588 P 65.

C. The grantee organizatior is the Institute for the Crippled and

Disabled of New York City (IC0).

D. The duration of the planning grant is one year. This report

represents total activities and accomplishments for the entire

year of the planning grant.

E. The formal starting date of the planning grant was

September I, 1964.

David Hall

Principal Investigator

Isabel P. Robinault, Ph.D.

Research Director

James N. Burrows

Project Director.

.1.

II. Purpose

The overall objective of this research is the development of a

system of vocational evaluation and training which is aimed to help persons

with mild mental retardation enter certain service occupations. Specifically,

it is desired to:

(I) Extend the TOWER SYSTEM of work evaluation to include those

work areas which both theory and practice indicate as the

most stable job placements for the mentally retarded. These

occupations include such less skilled and more auxiliary tasks

as those involved in the following work areas:

a. food handling and cafeteria work;

b. porter and building maintenance;c. messenger (inside and outside);

d. material handling, shipping and receiving;

e. laundry work;f. hospital aide;

g. other similar areas.

(2) Establishment of suitable supervised training programs in

both commercial and non-profit facilities.

It was proposed that this project take place in two phases:

Phase 1 (a one-year Planning Grant), and Phase 11 (a three-year Test

Development Grant). The initial proposal was for support of Phase I.

The Planning Phase was to provide the basis for support of Phase II.

During Phase I, the following preparatory procedures were to be

accomplished:

I. Carry through an analysis of the detailed work requirements

of the desired kinds of job placements, starting with a

survey of what has already been done in other centers;

2. Explore possible work samples and the kinds of evaluation

techniques which are required to tap potential, aptitudes

and interest in the suggested work areas;

3. Develop plans for the carrying out of suitable training

programs in the suggested work areas; the objective would

be to explore the possibility of securing the cooperation

of hospitals, and other non-profit institutions and com-

mercial firms for the carrying on of work-training

programs in these facilities, with supervision to be

supplied by the project staff;

4

42-

4. Work out the specific requirements of Phase 11 of thisprogram; it was anticipated that Phase II will involve the

a. actual development of the required work samples;b. the procedures of evaluation and training; c. as well

as the pilot testing needed to demonstrate the efficacy of

these procedures.

Ill. Justification of Project

Examination of current reports of the vocational rehabilitation

services being offered to the mentally retarded indicates that the core

services offered are typically situated in sheltered workshops (e.g. AHRC,

Goodwill Industries, the various programs of the Jewish Vocational Services,

etc.). While these programs have made a notable contribution to our under-

standing of the work problems of the mentally retarded, it should be noted that

the basic work experience offered by these workships is bench assembly. On the

other hand, where successful job placements are reported by these service pro-

jects, the placements are not made in factory assembly (where productivity

standards are typically too high for this client category), but rather in what

can be described as the auxiliary "helper" occupations, Law messenger,

trucker's helper, busboy, kitchen heiper, hospital aide, receiving platform

helper, stock helper, etc We are thus confronted with something of an apparent

inconsistency, in which the primary work training being offered to the mentally

retarded client is not clearly focused on the job he will fill once he enters

the unprotected labor market.

The current sheltered workshop programs attempt to resolve this incon-

sistency in two ways. First, they put forward the quite legitimate claim that

the primary need of most of these clients is the acquisition of appropriate

work habits and work behavior, in which these programs offer excellent training,

regardless of the particular tasks the client is asked to perform. Second, the

more advanced programs, such as AHRC, include programs which give the client

some supervised experience in various "non-productive" activities, such as

messenger work, food handling and preparation, material htindling, porter work,

etc. However, these activities are not the center of attention in the typical

sheltered workshop program, and appear to be less well-developed than the

procedures which focus on productive operations. It may be questioned whether

anyone has carried through a scientific analysis of the components involved in

the work of a messenger, developed a step-wise and standardized series of

evaluative tasks related to these components, to be followed by systematic

training in each of these component processes.

This Institute (ICD) has not only pioneered in the development of

work sample techniques as applied to the vocationallyhandicapped (the TOWER

SYSTEM), but is a recognized center for the training of potential worker evalu-

ators. Since 1957, under VRA Grant #I46 - T, over 130 persons from all sections

of the United States have been trained in the Tower Work Sample approach to

evaluation of the work potentials of the vocationally handicapped. Within this

group, we have noted an increasing number of trainees whose caseloads include

mentally retarded clients. Ten of these TOWER trained evaluators deal primarily,

with mental retardation in state schools, private and public schools, and

rehabilitation facilities. Another 26 former trainees have mentally retarded

clients within their general rehabilitation caseloads, in settings which are

scattered throughout the main geographic divisions of the country. It has

been noted that there have been many requests made to 1CD for Problem Clinics

on the issue of evaluating the work potential of the mentally retarded client.

It is recognized that the TOWER SYSTEM, in its present form, is aimed at a

higher skill level than is suitable for most mentally retarded persons, and

the Institute has had a number of queries which suggest a growing need to ex-

tend TOWER so that it will better serve the needs of this important client

category.

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We are proposing the extension of the TOWER approach to the requirements

of certain service occupations. It is likely that the proposed extension will

be useful not only for the mentally retarded 01:lig but also for a growing

group of clients who have other disabilities as well. The increasingly rapid

development of automation and mechanization is eliminating many jobs which were

primary placement resources for rehabilitees of many types. The resulting high

revels of productivity, and the general rise in the American standard of living

are also bringing about a long-term secular shift from the manufacturing, to the

service industries. It is logical to infer that the occupations associated with

personal service and human welfare will provide many more future occupational

opportunities than the kinds of work associated with manufacturing. Not only

will this expand potential employment for the mentally retarded if properly

evaluated and trained, but for other categories of the vocationally handicapped,

as well.

9,1".

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IV. METHODS OF PROCEDURE

A. Research Reading

As with any disability group, the scope of inherent problems are many and

varied. This is no less true with retarded and perhaps n some respects

even more so. Considerable material was reviewed to ascertain the scope

of (a) vocational problems inherent in the mentally retarded, (b) psycho-

logical, sociological and vocational determinants of the vocational feas-

ibility of the mentally retarded. A bibliography of books and papers from

medical, psychological and sociological sources that have greatest pertin-

ence to the vocational aims of the proposed research may be found at the

end of this report. Perhaps one of the most poignant guides to programing

needs and consideration for the mentally retarded is an article by Ralph

A. Peckham, in the American Journal of Mental Deficiency, 1951-52. 56.

448-453. This article provides an outline of "Problems in Job Adjustment

of Mentally Retarded." In addition to pointing out the problems, there

are also suggested solutions to certain categories of problems, as well

as an analytical breakdown of frequency of the problems, etc. This material

also provided a good insight into the retardate's possible functional

limitations, which would need evaluations. Thus, included as part of the

evaluation, it would provide an awareness of the retardate's actual limits

and permit amelioration of these deficiencies where the client showed a

capacity for it.

Another, and no less significant contribution to program development for

mentally retarded is the "Guide to Jobs for the Mentally Retarded" by

Peterson and Jones, American Institute for Research, Pittsburgh, Pa., 1964.

This is a resea6-ch project study which has produced a manual of training

procedures and offers an excellent guide to vocational program structuring.

-6-

It provides a breakdown of job activities in job classes and also in

specific job titles as listed in D.O.T.

The official definition of the American Association on Mental Deficiency

requires that a suspicion of mental retardation be established on the

basis of measured intelligence and confirmed by a clinical judgment as

to the individual's actual adaptive behavior. At the University of

Wisconsin conference on the "Vocational Rehabilitation of the Mentally

Retarded", the group designated as mildly retarded is "comprised of those

who, with proper preparation, can be fully capable of independent living

in the ccmmunity and gainful competitive employment. They require super-

vision and guidance under conditions of unusual social or economic dis-

tress. The moderately impaired are those retardates capable of maintaining

themselves in the community and of performing adequately in unskilled

work but who need some continuing supervision and assistance in adjusting

to even the mild social and economic stresses in their lives." (I? In

terms of psychometrics, the Guide for Selective Placement of Handicapped

Persons states that "mild refers to vocational impairment, as woutd be

expected with 1.Q.s of approximately 75-80; moderate for impairment re-

quiring special training and guidance as would be expected with I.Q.s of

about 50-70."(2) For the purposes of this study, we shall use the

designation of the American Association of Mental Deficiency wherein mild

retardation is considered to comprise those individuals having an I.Q.

between 50 -(3)

79.

B. Surveys

I. Facilities for the Mentally Retarded

A survey letter was formulated to obtain specific information relative

to scope and content of current operational procedures, from facilities

1'

that provide services for the mentally retarded, includi

workshops. (Exhibit A). Its purpose was to determine

content but also to find research studies being app

analysis of their application in various setting

We received a return of only 20 from the ori

Many replies, however,were accompanied byre

reports. These reports, even though lim

to this project, but showed little par

which are advocated in this project

bit A) with a summary of the res

project reports (Exhibit C).

planning of our proposed pro

2. Commercial Facilities

It is not only impracti

ment for determining

in a job situation

ties outside of

what ,,pecific

needed, and

Since w

in an

tio

ng sheltered

not only the program

lied and to make an

ginal 225 lettersimailed out.

search or demonstration project

lted in number, had parallel goals

allel to the approach or techniques

. A copy of the survey letter (Exhi-

Its (Exhibit B) and a list of specific

n our opinion these were beneficial in the

gram.

cal but impossible to develop any measuring instru-

vocational potential without knowing what is involved

. Therefore, we initiated a survey of selected facili-

the Institute for this reason, as well as to determine

job classes in the service level of occupations were most

in which mentally retarded might be evaluated and trained.

felt it essential to include a period of on-the-job experience

outside situation, we also solicited a reaction to future participa-

n by these outside facilities. During the formation of a survey letter,

it was realized that to have necessary information would require no less

than a personal contact. As a result, the survey letter became a letter

of introduction stating our interest and requesting an appointment to dis-

cuss the project in more detail and elicit their help on our project

(exhibit D).

With our concern for service area situations, contact letters were sent to a

variety of concerns employing both a variety of service jobs as well as provid-

ing possible outlet. for a number of placement. Letters were sent to the follow-

ing types of facilities; Hotels (chains), Hospitals, Restaurants (chains), and

commercial cleaning firms. Responses came primarily from hospitals. Therefore

appointments for further discussions were made with six hospitals.

Some replies by phone from other types of concerns verbalized negative interest

due to existing participation commitments with other programs, some indications

of fear in dealing with the retarded, lacK of interest in rehabilitation and

fear of being committed to extensive involvement beyond their immediate concern.

Some replies (verbal) indicated they did not want to know about the project at

all, and refused even to listen to a brief explanation on the phone.

Five of the six hospitals provided extensive assistance by giving information

on jobs, as well as by indicating that they would probably be able to participate

as an on-the-job training experience setting.

List of Hospital Facilities Willin to Coo erate with the Proitct

New York University Hospital568 First AvenueNew York N Y

Misericordia Hospital600 East 233rd StreetBronx, New York

Roosevelt Hospital9th Avenue at 59th StreetNew York N Y

St. Francis Hospital525 East 142nd StreetBronx, New York

Veterans Administration HospitalNew York, New York

Ail five facilities supplied photostatic copies of job descriptions from their

files. In addition to the specific job descriptions given, request was made

and granted for further discussion of detailed job activities with department

personnel at a later date after we reviewed the job descriptions. A list of

jobs for which we obtained specific factors may be found in the appendix

(Exhibit E).

We found that most of the job descriptions were quite general and, even though

they might be adequate for the usual employment requirement, they were insuffi-

cient to permit development of the necessary quality-sampling of work activities

that we needed to evaluate the vocational potential of the mentally retarded.

We then honored the permission granted to spend time with the department

personnel in the service areas, adding greatly to the previous information.

Cooperation was courteously given and when permission was requested to return

for a review of our formulated work activities, this too was freely given.

After formulating the work activities into a usable form, even with knowledge

of proper structuring, it is imperative that it be checked by personnel in the

field who are actively engaged in the work to assure adequate contact and fac-

tual procedures. These procedures were followed in all the concerns visited.

C. Job Information Summary

In order to gain the greatest significance from the specific job information,

all job specifications were assembled and compiled into analysis charts.

Chart number i shows the frequency of a particular activity incorporated in

all classes of service jobs (Exhibit F). Chart Number 2 shows prevalence of

basic job factors as they relate to various service jobs (Exhibit G). From

all material collected, it appeared that there might be a sufficient number of

these job activities to develop a preliminary evaluation procedure. If this

were so, we would be able to eliminate extensive evaluation of work activities

in a number of service level job classes, and to concentrate only on those

TR,

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job areas in which the client showed the greatest promise. This might also be

one answer to the contention that the retarded lack specific training in the

so-called incidental job activities, and that this may be a major reason for

their inability to hold on to a job. We are referring to those aspects of a

job which a normal population is assumed to be capable of doing already and

has had sufficient opportunity to acquire the ability on their own. Such an

activity might be as simple a thing as proper answering of the telephone or

properly transmitting important messages. The retarded must, however, be trained

in these facets, even though ghey may not be listed as requirements for a job.

Therefore it is proposed that these Elementary Job Activities become basic to

the evaluation and training of the retarded person for any job situation.

V. EMB8MALCOMEINI

At this time it was felt that sufficient information had been collected to

make a tentative program outline for a future Demonstration Project. Based on

the resulting analysis for the collection of job specifications from various

facilities, and those contained in "Guide for Jobs for Mentally Retarded", and

with realization of the importance of basic job factors to employability, we

compiled the following tentative outline for evaluation procedures of basic job

factors.

A. Evaluation of Basic Job Factors

I. Verbal Ability:

a. Telephoneb. Tape Recorderc. Direct conversationd. Verbal description

2. Numerical Ability

a. Countingb. Filing numericallyc. Weighingd. Measuring

3. Reading Ability:

a. Safety signsb. Direction signsC. Bldg. directoryd. Written directionse. Telephone Directoryf. Filing alphabeticallyg. Mail sorting

4. Writing Ability:

a. Printingb. Write directionsc. Names & Addressesd. Filling out forms

5. Travel Ability:

a. Busb. Subwayc. Walking

6. Basic Job Procedures:

a. Packingb. Wrappingc. Tyingd. Sorting:

I. Physical2. Color3. Size4. Weight

e. Locating by:

I. Number2. Word3. Symbol

f. Using:

I. Dials2. Gauges

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1,1910.12diltEt2E1.

7. Social Skills:

a. Self-Concept-Communication, ask for assistance, questions

b. Self expressionc. Sociabilityd. Work Independencee. Appearancef. Teamworkg. Adaptation to Work Environment

8. Time Factors:

a. Paceb. Attendancec. Simultaneityd. Timinge. Transition to new job situation

9. Performance Skills:

a. Accuracyb. DexterityC. Concentrationd. Choicee. Directionf. Memoryg. Transfer of Training

10. Work Attitude:

a. Attitude toward workb. Motivation toward workC. Response to instructionsd. Intereste. Response to pressuref. Task approachg. Reaction to unexpected job assignments

II. Tolerance:

a. Repetitivenessb. PerseveranceC. Staminad. Employment tolerance

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B. Evaluation of Service Job Activities

Initially, consideration was given to the exploration and development of

work activities for five service areas. Due to the time necessary to properly

structure the work activities, the number of areas were reduced to the three

areas having the greatest placement potential. The following tentative outline

of these areas, and specific job activities, illustrate both design and possible

content of the sampling of work activities for the specific job area evaluation.

It will be noted that the enumerated activities could be expanded to yield a

general basis for evaluation, as illustrated under Food Handling-Cleaning,

General.

I. Porter - Bldg. Maintenance

a. Gen. Bldg.: dusting, cleaning & polishing

b. Elevator operationC. Material handling (receiving & stocking supplies)

d. Furniture & Equipment moving

e. Light bulb & supply replacement

f. Trash collection and removal.

2. Food Handling:a. Cleaning, General

1. Sweeping2. Mopping3. Dusting4. Hand washing of walls and equipment

5. Polishingb. ServingC. Table settingd. Stockroom; sortinge. Floor cleaning and 'scrubbing

3. Hospital Service Workers:

a. Aides

1. Room cleaning & sterilizing

2. Set-up room cleaning carts- with replacement linens, etc.

3. Scrubbing4. Laboratory cleaning

5. Making beds6. Furniture moving7. Patient handling

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Since the formalization of the Tower Training Program at ICD, many evalu-

ators from all over the United States and some foreign countries have taken

training in the TOWER technique of developing work samples. During these

training courses, some of these trainees have written up initial work sample

procedures. These have not been developed to a point of completion. From this

collection of initial procedures, some have been selected to be used as a basis

for developing the necessary sampling of work activities for the service job

area. A list of these, along with check list acquired from other rehabilitation

facilities, which might be used as a basis for developing the necessary sampling

of work activities for the service job area. A list of these, along with check

list acquired from other rehabilitation facilities, which might be used as a

basic point for activities development, may be found in the appendix

(Exhibit H).

C. Develooment of Inter-Related Rptino Scale

Preliminary to the development of actual sampling of work activities,

there was an obvious need to develop a means of rating performance on the work

activities. During the compilation and analysis of job information, the

Principal Investigator developed the concept of a series of preliminary screen-

ing work activities dealing with the employability factors basic to the

retarded. It is felt that the resulting system has excellent potential

application, not only to this project but to the development of similar evalu-

ation procedures in other settings.

The rating system is comprised of a series of job activity profiles illus-

trating the minimum requirements for a job situation. There are two sets of

rating profiles (Exhibit 1, J). The first is a series of profiles illustrating

the minimum level of ability on basic employability factors as they relate to

the service jobs with which we are concerned. The numerical value is

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established on the basis of two general considerations:(1) The qualitative

merits c4 the job using a particular type of tool or equipment, and (2) The

settihg in which this specific activity will be used. The score for a parti-

cular factor or a particular job would be determined by an analysis of that

particular factor as it is performed in a regular employment setting.

The client's scores would be based on the same scale, 0-100, i.e., each

activity in each area would have a rating from 0-100. When the client's scores

are recorded for each factor they are plotted on the sPeeific job profiles,

thereby indicating the job for which he has the highest potential. This pro-

cedure is used on the Genaral Employability factors first, which would eliminate

extensive testing in areas in which the client showed no potential. When the

specific job area evaluation is completed, both the employability ratings and

the specific job ratings are recorded on the summary rating form. This allows

a comparison of the job area and specific jobs having the highest ratings,

upon which to make recommendations.

D. Intermediate Training

Training must not only provide supervision for developing job skills but

also provide an accompanying opportunity to experience the pressures, inter-

ruptions, and demands of an actual job situation.

In the development of training programs, it was felt that incorporating

these job demands into an Intermediate Training Period would serve to eliminate

confusion and unawareness of these factors in an on-the-job experience setting.

It was determined that the regular job setting of 1CD could provide these

factors.

Areas at ICD which would be used to serve the training program needs are:

I. Cafeteria (food handling), 2. Maintenance Dapt. (Porter and Building Main-

tenance), 3. Infirmary, 0.1. and P.T. Depts., (Hospital Service Workers).

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Training in these areas would not be designed to train for a specific job title

within a job class, but to give training in a job class which would allow the

client to have a broader background to apply to a specific job title. As an

example: in the area of Porter and Building Maintenance, thore may be a broad

number of job titles in which many activities overlap. It would be much more

advantageous to the client to be able to comply with job title variations, thus

giving him greater job security.

Training Curriculum Outline

The following list of activities for the training areas is tentative. It will

be nottid that various job titles would be covered by these training programs.

I. JANITORIAL & BUILDING MAINTENANCE WORKER (HOUSEMAN, HOUSECLEANER, WALL

WASHER, PORTER. ETC.) -12 Weeks.

(I) General CleaningSweep, clean dustEmpty trashBurn trashEmpty and clean ashtraysSort shelve suppliesPolishing metalwork.

(2) Heavy CleaningScrubbing floorsBurn trashWash windowsWash walls

(3) Use of machinesWax floorsMinor furniture repairs

(4) Elevator OperationPassengerFreight

2 Weeks

4 weeks

2 weeks

2 weeks

(5) Overall application of above duties with

regard to regular agency requests 2 weeks

II. FOOD SERVICE - FOOD HANDLING (HELPER, DINING ROOM, DISHWASHER

HOSPITAL liELPER. KITCHEN HELPER& HOPITAL FOOD sERvico 12 weeks.

I. Bussing 2 weeks.

Clean dishes from table, cart, traysLift and carry tray with food, dishesScrape dishes, trays, pansReplenish table supplies, salt, napkins, silverMop floorsClean tables.

2. Dishwashing 2 weeks

Use of hand, dishwashing apparatusScrubbing utensils and potsScour work tables, meat blocks, counter

3. Simple food handling 2 weeks

Preparing simple foods, coffeeWrap food for carryoutsReplenish beverages, rolls, serve relishesCarry, serve food outside dining room.

4. Advanced food handling 6 weeksSandwish preparation for individual ordersPortion out food to platesPreparation of saladsCashbox

III. HOSPITAL SERVICE WORKERS ( ORDERLY, MED. SERV., WAITERHOSPITAL. ETC, 12 weeks.

I. General CleaningFad, sort, count, distribute linensEmpty bed pansClean lavatoriesFill water pitchersCarry food trays

Heavy CleaningChange and make bedsMop floors

2 weeks

2 weeks

Patient Care 6 weeks

Lift and assist patients on and off bedsBathe patientsDress and undress patientsFeed patientsGive alcohol rub or massage

General practice of varied assignments 2 weeks

Supervisory personnel for training will be discussed in the section covering all

project personnel. All clients would be afforded an opportunLty to explore the

training work setting during the evaluation period. It has often been questioned

as to how much effect exposure to a job setting has on a client's efforts during

the evaluation period. This is a question in which we hope to gain some insight.

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E. gn:The-job Experience.A Placement

No person, regardless of prior experience of formal training, would be

expected to move into a new job situation without some degree of orientation

to that particular setting, It is with this in mind that the program proposal

recommended using an outside (Outside ICD) facility in which the client would

experience the need for adapting learned skills and information to an actual job

setting. In this job setting the client would work as a regular employee under

that facility's supervisory personnel.

Project staff would be available, however, to handle initial orientation

and any problems which might arise during this period of the client's program.

As was mentioned earlier, of the six hospitals surveyed, five indicated a tenta-

tive willingness to cooperate with the project. Many questions were raised by

hospital personnel. Among these questions was: who has the ultimate responsi-

bility for the client? It was explained that the client was still under our

responsibility. During this period the client would be receiving a training

wage for this work. This would be a slight increase over the fee paid to the

client during his Intermediate Training period. It was also made clear that

in the event that an outside facility was desirous of permanently hiring a

client during this period, they might do so only after a minimum of three

months in that phase of the client's program.

Placement would be handled by a project staff counselor with the assistance

of the regular Institute's counseling and placement staff. Field visits, tele-

phone solicitations and mail promotions would be undertaken by the project

placement counselor.

F. Recommendations for Demonstration Prolest

I. Project Staff

During the current year of this planning project the staff has con-

sisted of: the Principal Investigator and the project secretary, plus 1CD

executive and consultative staff.

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Recommendation for staff for a Demonstration Proposal consist of, in addition

to present personnel:

2 Evaluators

2 Training Supervisors

1 Field Supervisor

1 Counselor

2. Client Source

We plan to work with 30 clients during this three year project. The

population of choice for a Demonstration Project that follcmed this Planning

Project could come from the Division of Vocational Rehabilitation. Originally

it was felt that clients might be selected from referrals by various agencies.

However, two factors determined the basis for requesting the use of D.V.R. as

the only source of referrals. First, using a single agency, which has exten-

sive rolls of potential population already screened and classified, would

require less time in screening. Second, there would be fewer problems in

orienting the staff of a single agency to research needs.

Therefore a meeting was arranged with the State DVR personnel. Criteria

for accepting clients into a Demonstration Project were revised by mutual

agreement at the ICD-DVR meeting of April 8, 1965:

I. 1.Q. rating between 50-79 on WAIS psychological battery.

2. Males and females, 16-35 years of age.

3. Literacy to a minimum of 2nd grade.

4. No significant physical and/or emotional problems which would

interfere with the employment; no hospitalization in a mental

institution during the past 3 years.

5. Independent ADL and travel necessary for competitive employment,

or capable of learning some prior to entering vocational training

phase of the project.

6. Adequate social and emotional maturity for evaluation and training

in a group setting within a vocational rehabilitation center.

7. No physical impairment which might preclude adequate functioning in

a service area occupation, such as restrictive losses of hearing

and vision or inability to communicate.

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3. &commended Client Prociremahedule:

Time Evaluation Intermediate Trai ni nq On-The-Job Experience___

3 Month 10 Clients

3 Month 10 Clients

...MI.

10 Clients

3 Month 10 Clients 10 Clients

3 Month 10 Clients

3 Month Follow-Up and

10 Clients

TraininciProgram Chancics0

,

,

3 Month

3 Month 10 Clients

3 Month 10 Clients

3 MonthWork Sample

Test Deve opment and

3 Month ollow Us

4 Month Preparation of Manual of Procedures

Hours for Evaluation will be 9-3 daily; hours for Intermediate Training will

be 9-4 daily; hours for On-The-Job Training in an outside facility will be

9-5 daily. Clients will not be paid during the Evaluation. However, they

might receive 280 an hour during the Intermediate Training at ICD and 500 an

hour during their On-The-Job Training at community facility.

The above ,arrangement allows time necessary for feed back from initial clients

processed through the on-the-job experience. Time lapses would be used to

analyze data collected during procedure for making any necessary changes in

program content or structure prior to accepting last group of clients.

-21-

4. Outline for Prgposed DemonstrationjEmAgEt.

This outline is incorporated at this point to illustrate the overall

program content and structural procedure toward which the Planning Project

aimed. (Referral Source: DVR)

I. Intake

A. Counselor InterviewB. Medical ExaminationC. Social InterviewD. Psychological Review

II. Specialist Examination

A. Social ServiceB. Psychological

III. Evaluation

A. Employability Evaluation (Evaluation Unit at ICD)

B. Job Area Evaluation (in Evaluation Unit at ICD and regular

job situation at ICD).

IV. Intermediate Training at ICD

A. Food HandlingB. Perter, Building MaintenanceC. Hospital Sarvice Workers

V. On-The-Job training Experience

A. Hospital

VI. Placement

A. HospitalB. HotelsC. RestaurantsD. Etc.

PHIBIT A.

Institute for the Crippled and Disabled

400 First Avenue, New York, N.Y.

Dear Sir:

I am currently engaged in the planning stage of a V.R.A. sponsored

research program relative to the vocational rehabilitation of the mentally

retarded.

It would be most helpful if you could provide me with the following

information:

I. The number of Retarded, as compared to other disability

types, in your total case load. Also including the I.Q. range

and how it is determined.

2. Training programs; which ones, and how they are conducted.

3. An outline of your evaluation program, re content, and admin-

istration procedures.4. Areas of placement (job types)5. Procedures and/or techniques used in placement.

6. Any related services which you feel are pertinent to or

necessary for adequate development of vocational potential,

such as social or.group therapy, etc.

The above information will aid to eliminate outmoded procedures, while

simultaneously developing and standardizing new or unique ones.

Due to the limited time for planning and the need to obtain the above

information from various facilities, it is necessary to ask your co-

operation in returning this information as soon as possible.

Hoping to hear from you soon, I remain,

Yours truly,

David I. HallChief InvestigatorSpecial ResearchI.C.D.

AR RV AC1 I S S RVI A

EXHIBIT 8

NO. FACILITIES REPLYING aNO. OF STATES REPRESENTED 23

STATES RANKING IN NO. OF REPLI. New York2. California3. Louisiana, Florida

TOTAL NUMBER OF CLIENTS SE

RANGE IN NO. OF CLIENTS

AVERAGE NO. OF CLIENTS

SOURCE OF REFERRAL INI. D.V.R.2. Local Day Care Center3. St. Sch. & Hosp.

NO REQUESTS MAILED OUT 224

I ES

, New Jersey

RVED (YEAR) 20422

SERVED: From 12 to 600 (38 of 54 Replying)

SERVED 93.92

RANKING ORDER

I.Q. RANGE 0 to

AVERAGE I.Q. OF

SER IC S

23

ALL CLIENTS 71 (29 Facilities)

NO. OF FACILITIES PERCENTAGE OF TOTAL

REPLY I FACILITIES REPLYING

EVALUATION

,

38 70 3%

COUNSELING & GUIDANCE 30 55.5%

46.21P.A.T. 25

SO ADJ SERVICE 17 31 41

PERM. WORKSHOP 37 68.5%

TRAINING;Domestic 19 35.11

Commercial Service 24 44.4%

Production Work 28

Semi-Skilled 22 40.7%

Skilled 4 7.4%

I PLACEMENT 43 79.61

l - JECT RTS 4' B TAT1 FACI ISFR

EXHIBIT C

F LdmaimI. DLitt a ni-1.,&apsaiati n Center for Mentally Re t rde The Bobby Dodd

Workshop), Progress Report RD 551, Date Reported: January, 1964. Add: 1100

Sylvan Road, S.W. Atlanta, Georgia. Sponsored by The Atlanta Association

for Retarded Children, Inc. In cooperation with the Office of Vocational

Rehabilitation Department of Health, Education and Welfare, Washington, D.C.

"The Project is designed to demonstrate that mentally retarded young adults

who were previously considered unemployable could attain, through provision

of vocational rehabilitation services, vocational goals commensurate with

their ability, and assume appropriate and satisfying roles in community living."

2. erative cational a tern for n-School entail Retarded Yo th

(Training and Work Center for the Handicapped) Project No. RD-I)89, Date

Reported: Sept.1, 1963 - August 31, 1964. Add: 29 South Sixth St., Newark 10,

N.J. Sponsored by: Occupational Center of Essex County, Inc.

"The purpose of ther.project is to develop and demonstrate the techniques of

meeting the vocational rehabilitation needs of mentally retarded youth who are

completing their last year of special education in a public school system, a

state vocational rehabilitation agency and community workshop."

3. Placement of the Cerebral Palsied and Others Throu h Evaluation and

Trainind. A project of the Memphis Goodwill Industries. VRA Project 490,

Add: 94 No. Second St., Memphis, Tenn. Sponsored in part by a demonstration

grant, from the Vocational Rehabilitation Administration, Dept. of Health,

Education and Welfare, Washington, D.C. 20025. "The project was designed to

develop means for helping the severely handicapped to become integrated into

the working life of the community whenever possible. The purpose was also to

establish a format by which any other community could do the same thing, if

the Memphis effort were considered successful."

EXHIBIT C-(2)

4. y..........3...jiaorkareitiensi)Services for Mentally Retarded Adults.

Selected Demonstration project #278. Date of Report: Dec. 1958 - November 30,

1962. Add: Goodwill Industries of Greater Kansas City, 1817 Campbell, Kansas

City, Mo. Sponsored by: The Vocational Rehabilitation Administration, U. S.

Dept. of Health, Education and Welfare. The Missouri Section for Vocational

Rehabilitation. The Kansas Vocational Rehabilitation Service. "A handbook on

organization and operation of a specialized habilitation program in a multiple

handicap workshop. A discussion of essential work preparation services. A

discussion of essential citizenship preparation services."

5. Develo ent of Occu ational Evaluation and Trainin Center f r the entail

Retarded.

Projec*#308. Date reported: September 1963. Add: Tacoma Goodwill Industries

Rehabilitation Center, 2536 Tacoma Avenue South, Tacoma, Washington.

Sponsored by: Vocational Rehabilitation Administration, U. S. Dept. of

Health, Education and Welfare, Washington, D. C. "The project contained in

this report has enabled this agency to develop a program and extend services

to a group of citizens within the community who have been in acute need of

rehabilitation measures."

Institute for the Crippled and Disabled400 First Avenue, New York, N.Y.

Dear Sir:

Exhibit

We are currently engaged in the planning stage of a Training and

Research Program for the Mentally Retarded. The purpose of the program

is the development of an extensive vocational rehabilitation program

consisting of:

I. Evaluation of vocational skills and potential of high level

retarded clients.

2. Training in an appropriate service area, and, on-the-jobpractical experience.

At this time we are requesting your assistance and guidance in

acquiring specific information on service area jobs, as well as deter-

mining the practicability of using organizations such as yours for an

on-the-job practical experience, which would not begin for approximately

one year. Your extensive experience could currently help us determine:

I. Those service areas for which there is an industrial need, and

2. The actual nature of these job areas upon which to base future

evaluation and training programs for the Mentally Retarded and

other handicapped groups.

Being aware of the complexity of your operation, I feel you could

provide considerable insight into the many facets of this undertaking.

I would appreciate an opportunity, at your earliest convenience, to

visit your facility and discuss this program with you or a representative

of your organization.

Sincerely,

David L. HallChief InvestigatorSpecie) Research.

Exhibit E

Job Information From pospitals

wft. ja-Lgni

I. Tray Assembler2. Porter3. Elevator operator4. Cafeteria Man/Woman5. Folder/Sorter6. Dishwasher

St. Francis Hospital

I. Orderly2. Counter Girl3. Diet Aide4. Porter (housekeeping)5. Head Dishwasher6. Dishwasher (Dietary Dept.)7. Nursing Aide

Misericordia Hospital

I. Pot Washer2. Porter, Dietary3. Dishwasher4. Counter Server5. Groundsman6. Incinerator Man

7. Attendant8. Attendant, Central Supply9. Nurse's Aide

Guide to Jobs for the Mentally Retarded

I. Stock Boy or Girl - WO Cent Store

2. Messenger, general office3. Wrapper or Packer, mail order house4. Day Worker, housecleaning5. Helper, Diping room6. Dishwasher, restaurant, hospital7. Helper, restaurant clean-up

iL Helper, Hospital food service

9. Helper, building cleaning and maintenance.

10. Helper, building housekeepingII. Building Porter12. Assistant, Greenhouse13. Helper, Park and Grounds Maintenance14. Delivery Boy, local deliveries

Exhibit E (continued)

100 SPECIFICATIONS

Acquired from the Following Facilities

Roosevelt Hospital

1. Maid2. Cook's Helper3. Nurse's Aide (Auxiliary Nursing Dept.)4. Float Maid5. Checkout Aides6. Basement Porter7. Evening Porter (Operation Room)8. Maid - Night9. Porters10. Early Porters ( 5 A.M. shift)II. Wall Washer12. Porter (Garbage Removal)13. Nurse's Aide (Cystoscopy Dept.)14. Orderly - Recovery Room15. Nursing Alde - Evening, Day.

16. Messenger17. Early Maid18. Special Area Porters19. Porter (Operating Room)20. Dishwashers21. Utility Men22. Food Service Aide I (Eve.)

23. Cafeteria Servers24. Waitress (Hospitality Shop)25. Orderly (Auxiliary Nursing)26. Nurse's Aide (Cystoscopy)27. Sorter (Laundry)28. Linen Distributor29. Messenger File Clerk30. Feeder - Folders31. Utility Girl32. Uniform Girl.

Veterans Administration Hospital

I. Food Service and Food Production Section2. Warehouseman - Laborer (Supply Division)3. Mail Clerk4. Housekeeping Aide5. Housekeeping Aide (Rubbish Removal Unit)6. Housekeeping Aide (General Cleaning Unit)7. Gardner - Laborer8. Housekeeping Aide (Soiled Linen Unit)

9. Central Service Assistant

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Exhibit H

Work Samples for Service Areas to be Develcmg

I. General Bldg. cleaninglest - D. R. Ferrier (TOWER Trainee)

Tests: 01 Gen. Cleaning test sweeping#2 " " mopping#3 " " machine buffing & self polishing wax

11 #4 " " dusting#5 " " wall washing

2. Domestic Worker test - J. R. Allen (TOWER trainee)

Tests: #1 Lifting, carrying, following directions

#2 House cleaning-#3 _Tidying#4 Handling dishes#5 Clothes care#6 Carryover (retention of previous procedure test #4)

The above test same application in all three areas

for development.

3. Activities check list - Not structured test situations

a. Porter Evaluation form - Max Dubrow, Sheltered Workshop

b. Work check list for Janitor (Porter) & Housekeeping -

W. Va. State D.V.R. Center

Nurse'sTest #1

" #2u #3" #4u #5

Nurse'sTest #1

" #2if #3

" #4u #5

Aide (Auxiliary) - Virginia S. Leitner (TOWER Trainee)

Use of thermometer (using visual aide)

Taking a subject's temperatureTaking a subject's pulseFeeding a helpless patientBed making

Aide Test (Series II) - Williams, Nancy OTR (TOWER Trainee)

Turning helpless patient in bed

Bed making with11 II

Dressing a patientUse of wheel chairTransfer of patient from bed to wheelchair

Laboratory Aide - F. Evelyn Marsh (TOWER Trainee)

Test #1 Housekeeping - cleaning: sinks, table, counters, shelves.

" #2 sweeping

" #3 Wash laboratory glassware (include test tubes, slides& coverslips)

Activities checklist - not structured test situations

Work checklist for Nurse's Aide & OrderlyW. Va. Voc. Rehab. Center (D.V.R.)

Exhibit H (Continued)

4. Cook's Helper - Al. Carlisle (TOWER Trainee)Test #1 - General cleaning (Porter Work) (Domestic Dish. Wash)

" #2 - Peeling & cutting" #3 - Sandwich makirig" #4 - Use of Stove" 05 - Measuring units (for food)" #6 - Cooking from recipe

5. Activities Check List - Not structured test situations.a. Cafeteria Evaluation from - Max Dubrow Sheleterd Workshopb. Work check list for kitchen helper and/or dishwasher

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BIBLIOGRAPHY

I. Special Problems in Vocational Rehabilitation of the Mentally Retarded.(Conference proceedings - Madison, Wis. Nov. 1963) U.S.Dept. of HealthEducation and Welfare, Vocational Rehabilitation Administration.Rehabilitation Service Series 065-16.

2. Reprint of: "Handbook of Interviewing Aids for Special Disabilities", AGuide for Selective Placement of Handicapped Persons. "Handbook" -

Developed by New Jersey State Employment Service, Division of EmploymentSecurity, Department of Labor and Industry, State of New Jersey.(Reprint: W. Va. Department of Employment Security, Charleston, W. Va.1957).

3. %mi.& Subnormality; Biological, Psychological and Cultural Factors."Richard L. Mastland, Seymour B. Sarason and Thomas Gladwin. New York,

Basic Books, Inc., 1958

4. "Psychological Problems in Mental Deficiency." Seymour B. Sarason,Harper & Row, New York, 1959.

5. "The Use of the Vineland Social Maturity Scale in the Planning of anEducational Program for the Non-Institutionalized Low-Grade MentallyDeficient Children." Genetic Psychology Monograph by Monroe G.Gottsegen, 1957.

6. "The Mentally Retarded and their Vocational Rehabilitation." AResource Handbook, National Association for Retarded Children -William A. Frankel, Ph.D., Consultant, 1961.

7. "Guide to Placement of Mentally Retarded." President's Committee on

Employment of the Handicapped, in cooperation with NARC & U. S.Employment Service, Bureau of Employment SecuritY, U.S.Dept. of Labor,1964.

8. "Evaluating and Developing Vocational Potential of InstitutionalizedRetarded Adolescents" Edited by J. J. Parniky, Ph.D., Harris Kahn, Ph.D.,Edward Johnstone Training & Research Center, VRA Grant 1963.

9. "Working for Maturity" Mac Dubrow, Ph.D., Jerome Nitzberg, Jack Tobias,AHRC Workshop, New York, 1962.

10. "Guide to Jobs for the Mentally Retarded" Revised Edition, Richard O.Peterson and Edna M. Jones, American Institute for Research, Pitts-burgh, Pa. 1964.

II. "Readiness Evaluation" OVR Grant 0375, Federation of the Handicapped,High School Homebound Project, Shirley Jenkins, Ph.D., ResearchConsultant, 1959.

12. "habilitation of Mentally Retarded Youth", MacDonald Training CenterFoundation, Tampa, Fla., 1959.

ma8LIOgmeux.1

13. "Mental Retardation: Readings & Resources: Edited by Jerome H.

Rothstein, Hold, Rinehart, Winston, New York 1961.

14. "Adjusting People to Work" Jewish Vocational Services & Employment

Center, William Gellman, Norman Gendel, Nathan M. Glasser, Simon B.

Friedman and Walter Neff, 1956.

15. "A Survey and Study of State Institutions for the Mentally Retarded

in the U. S., Vol. 11" Committee on Residential C re, NARC, New York,

1963.

16. "Work Evaluation and Employment Preparation Services for Mentally

Retarded Adults", Institute on Sheltered Workshop Services for the

Mentally Retarded. University of Kansas, Goodwill Industries of

America, Inc., 1961.

17. "A Scale of Employability for Handicapped Persons", Monograph #4

Jewish Vocational Service, Chicago, III., 1963.

In addition to the above listing of specific reading material, a review

of at least two dozen project reports from various facilities such as:

Workshops, Institutional Centers, and Vocational Rehabilitation Centers

are included. Organizations represented include Goodwill Industries,

AHRC Workshops, as well as State rehabilitation facilities.

DALIMEHX.S.Qadiamil.

I. "The Exceptional Child Faces Adulthood." Woods Schools, Langhorne, Pa.

2. "Voca;ional Rehabilitation for the Mentally Retarded." DiMichael,

Salvatore G. ed. Series 1123. Washington, D.C., U.S.Federal Security

Agency, Offfce of Voca. Rehab., 1950.

3. "Progress Reports." Herber, William E., and Davis. In Personnel &

Guidance Journal, March, 1961.

4. "Mental Retardation." Seven, Harvey A., and Herber, A review of

Research, Chicago, Univerity of Chicago Press, 1964.

5. "Social Changes in a Treatment Center for the Severely Retarded."

(report) Orzach, Louis H., New York, Oct. 1965.

6. "Rehabilitation for the Adult Retarded" Dybwad, Gunner. In: Amer.

Journ. of Public Health, July 1961.

7. "The Training School Bulletin." Vineland Training School, New Jersey,

Sept. 1960.

8. "A Scale of Employment for Handicapped Persons." Gellman, William

Jewish Vocational Service, Chicago, III., 1963.

9. "Directory of Sheltered Workshops Serving the Mentally Retarded."

National Association for Retarded Children, New York NHRC, 1964.

10. "A Survey & Study of State Institutions." National Association for

Retarded Children. A Survey and Study of State Institutions, by the

Committee on Residential Care NHRC, New York, 1963.

II. "Job Description & Organizational Analysis for Hospitals and Retarded

Health Service." U.S.Dept. of Labor, Bureau of Employment Security and

U. S. Employment Service, Washington , 1962.

12. "The Culturally Deprived Child.? Riessman, Frank, New York, Harper & Row,

1962.

13. "Terminology and Concepts in Mental Retardation." Joel R. 0 vitz, New York

Bureau of Publication, Columbia University, 1964.

14. "Children Mentally Retarded & their Vocational Rehabilitation."

(pamphlet) - National Association for Retarded Children, Vocational

Rehabilitation & Sheltered Workshop Committee, New York Jan. 1959.

15. "The Psychiatric Profession" Rushing, William A., Chapel Hill, University

of North Carolina, 1964.